An overview
While we all experience situations in life when we feel sad or low and it is completely normal to feel that. However, some people experience these feelings with great intensity for long periods of time (weeks, months or years) and many a times without any apparent reason, this is a signal of clinical depression. Depression affects how you feel about yourself and it impacts both your physical and mental health. The feeling is often accompanied by a sense of hopelessness and lack of energy and it interferes with the affected person’s work as well as personal relationships. A depressed person finds it very hard to enjoy life.

As per several studies, more than 20% Indians suffer from depression at some point in their lives and women are twice more likely to be diagnosed with depression than men. Depression is not a sign of weakness nor it has to do anything with the personality.

The good news is that depression is a treatable medical condition and a range of treatments are available to help people suffering from depression.
Symptoms & Signs
If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:
  • Feelings of helplessness and worthlessness
  • Feelings of pessimism
  • Feeling restless, sad or anxious most of the time
  • Difficulty in concentrating or decision making
  • Feeling irritable all day
  • Decrease in energy or constant fatigue
  • Change in sleeping patterns – over sleeping or lack of sleep
  • Feeling restless or having trouble sitting still
  • Change in weight or appetite
  • Digestive problems, aches, pain or cramps for no clear physical reason
  • Thoughts of death or suicide, or suicide attempts
  • Headaches, or digestive problems without a clear physical cause
  • Causes
    It's not entirely clear what can cause depression, though a number of things are often linked to its development. It is believed depression is a result of complex interaction and combination of biological, psychological, and social factors.

  • Certain Life Events - Experiencing difficulties such as unemployment, being in an abusive or uncaring relationship, loneliness, prolonged work stress, for a long period of time are likely to cause depression. In addition, recent events such as lose of a loved one or a combination of long term and recent events can also ‘trigger' depression.

  • Family History of Depression (Genetics) - It has been observed that in some families depression occurs generation after generation, which points to both genetic and parental factors. However, it does not mean that it can't occur in people who have no family history of depression.

  • Serious Medical Illness – Often physical changes in the body impact mental changes. Medical illnesses or the stress of dealing with medical illnesses such as cancer, a heart attack and hormonal disorders can cause depression, making the sick person unwilling to care for his or her physical needs and thus aggravating the situation.

  • Personality Issues – People with low self-esteem or those with pessimistic outlook about the world in general or those who are easily overwhelmed by stress, are prone to depression.

  • Drug Abuse - More than 30% of people with substance abuse problems also experience symptoms of clinical depression.

  • Certain Medication - Depression is a side effect of many medications including drugs such as Accutane to treat acne. Depression is also a possible side effect of many drugs used to treat conditions such as anxiety, insomnia, high blood pressure and menopausal symptoms
  • Major Depressive Disorder
    This is the most common form of depression and is characterized by persistent feeling of sadness or low mood and a lack of interest in usual activities for more than 2 weeks. It affects all facets of the person’s life, including work, home life and personal relationships. A person suffering with this kind of depression finds it difficult to do anything or get motivated, and even going to seek treatment for this condition can be challenging.
    Bipolar Disorder
    This is a severe form of depression, where a person experiences episodes of depression and maniac behavior, with periods of a normal mood in-between. Mania is essentially the opposite of depression, where the person feels on top of the world with little need for sleep, and has a lot of energy. In some cases, the person even loses touch with reality and has episodes of psychosis. Bipolar Disorder often gets misdiagnosed as accurate diagnosis is dependent upon the person being observed for an episode of mania. As a result, bipolar disorder is often misdiagnosed as alcohol or drug abuse, attention deficit hyperactivity disorder (ADHD) or schizophrenia.
    Psychotic Depression
    Psychosis is an abnormal condition in the mind which makes people lose touch with reality. In this type of depression, people can face hallucinations, experience negative events which are not actually occurring, be delusional and/or feel paranoid because they feel they are constantly being followed or that something bad could happen to them.
    Seasonal Affective Disorder (SAD)
    SAD is a seasonal mood disorder which is believed to occur due to the variation in light exposure during the various seasons. It's characterized by mood disturbances and other depression symptoms but it begin and end in a particular season. The more common form of SAD is winter blues, where people are diagnosed with the symptoms of depression just during the winter months. People with SAD depression are likely to experience oversleeping, overeating and weight gain.
    Adjustment Disorder with Depressed Mood
    This type of depression is diagnosed when a person is adjusting to some new change in his/her life that is causing a great deal of stress. It is possible for people to be suffering from this kind of disorder even when they are experiencing a good event in their lives such as marriage or becoming a parent. Since this form of depression requires people to have a little more support in their lives during stressful times, treatment involves counseling and is generally time-limited and simple.
    Postnatal Depression
    Women can experience depression during their pregnancy or after giving birth. Usually this change in mood due to hormones is termed as ‘baby blues’, but when these baby blues last longer than normal, and with more severe symptoms, it leads to postnatal or postpartum depression. Symptoms include persistent sadness, reduced desire for sex, crying episodes, anxiety, and irritability. It's common and affects more than 10% of women within a year of giving birth. It can also affect fathers although that is not so common.
    Assessment & Diagnosis
    Certain assessment tests can help figure out the exact problems that could be causing your depression symptoms:

  • Psychological Assessment - Your psychologist or psychiatrist will ask about your symptoms, feelings and behavior patterns and you might be asked to fill out a questionnaire.

  • Lab Tests - In a few cases, your psychiatrist may also reccomend you to get your thyroid test done to make sure it's functioning properly.

  • Treatment
    There are many ways that help people recover from depression and these vary from person to person. However, there are a range of effective treatments that have proved to be effective in treating depression and they usually involve psychotherapy and/or medication.

  • Psychological Treatment (Psychotherapy) - In mild to moderate cases of depression, psychotherapy treatment works very well. It helps in change of thinking patterns for people suffering from depression, which improves the coping skills to deal with life's stresses and conflicts. While different types of psychotherapies are existing, the most effective one is Cognitive Behavioral Therapy (CBT).

  • Medication- In cases of more severe depression, psychotherapy along with medical treatment (prescribed by psychiatrists) can be used to treat depression. The main medical treatment is antidepressant medication, which can be very useful in the treatment severe depression and some anxiety disorders.

  • Apart from these main forms of treatment, maintaining a healthier lifestyle, finding support groups and adopting methods of relaxation techniques could also help cure depression.
    How Therapy Works
    There are a variety of therapeutic approaches used for the treatment of depression. These approaches range from cognitive behavioral therapy to behavioral therapy to interpersonal therapy. Both individual as well as group therapies are also used, depending upon the severity of the depression and individual comfort.

    However, Cognitive-behavioral therapy remains the most commonly used and effective therapy for treating depression. Several research studies have proved the safety and effectiveness of CBT in treating people, of all age groups, suffering from depression. CBT is a structured treatment process which emphasizes on the fact that the way we think (cognition) and act (behaviour) eventually affects the way we feel. It changes the thoughts and behaviour pattern of an individual by teaching to think rationally about common difficulties and hence shifting negative or unhelpful thought patterns towards a more positive and problem-solving approach.

    CBT involves working with a professional therapist to identify and change thought/behaviour patterns that are causing depression and is also well-suited to be delivered online using video or audio technology.
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    Depression is a serious but treatable problem. If you or any of your close ones suffer from it then seek medical assistance at the earliest.